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Early Lung Cancer Action Project: overall design and findings from baseline screening
C I Henschke1, D I McCauley, D F Yankelevitz
1Weill Medical College of Cornell University and New York Presbyterian Hospital, NY 10021, USA. chensch@mail.med.cornell.edu
Lancet (London, England)
|July 17, 1999
Summary
Low-dose CT screening detects more lung cancers, including early-stage disease, in high-risk individuals. While false positives occur, invasive procedures are minimized, improving early lung cancer detection rates.
Area of Science:
- Pulmonology
- Radiology
- Oncology
Background:
- The Early Lung Cancer Action Project (ELCAP) aimed to assess low-radiation-dose computed tomography (low-dose CT) for lung cancer screening.
- This report details the baseline findings of the ELCAP study.
Purpose of the Study:
- To evaluate the effectiveness of low-dose CT in screening individuals at high risk for lung cancer.
- To compare the detection rates of lung nodules and cancers between low-dose CT and chest radiography.
Main Methods:
- 1000 asymptomatic volunteers aged 60+ with a smoking history underwent low-dose CT and chest radiography.
- Diagnostic protocols for screen-detected non-calcified nodules were based on ELCAP recommendations, including short-term follow-up for small nodules.
Main Results:
- Low-dose CT detected significantly more non-calcified nodules (23%) and cancers (2.7%) compared to chest radiography (7% and 0.7%, respectively).
- Early-stage (Stage I) lung cancer was detected in 2.3% by CT versus 0.4% by radiography.
- Of 27 cancers detected by CT, 26 were resectable, and invasive procedures were primarily performed on participants with malignant nodules.
Conclusions:
- Low-dose CT enhances the detection of small non-calcified nodules, facilitating earlier lung cancer diagnosis.
- Despite a higher rate of false-positive findings, low-dose CT screening can be managed with minimal invasive diagnostic procedures, leading to earlier and more curable cancer detection.
